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    Wednesday, February 09, 2005

    War Medicine: The battlefield has always been fertile ground for medical advancements, traditionally at the hands of surgeons. In Iraq, the anesthesiologists take their place in the march of progress:

    Six months after the first wounded started coming home from Iraq, Buckenmaier flew to Baghdad with a laptop, a digital camera, a satellite phone, a leatherbound journal, a 9-mm Beretta, and his bag of pain pumps.

    And here's what he does with his travel kit:

    ...When Buckenmaier asked him to estimate his pain on a scale of 0 to 10, he said 10, "the worst pain imaginable." Wilhelm had been carried into the OR for debridement, the harrowing process of removing dirt and dead tissue from a wound. Buckenmaier got out his bag and went to work.

    First he used a millivolt stimulator to probe for leg nerves that were still functioning. The soldier's ankle flexed - a sign that the stimulator had found the nerves serving the injured area. Then Buckenmaier placed two blocks by inserting ultrafine catheters into Wilhelm's back and thigh to bathe his sciatic and lumbar nerves in a drug called mepivacaine.

    Throughout the 85-minute operation, Wilhelm remained awake and talking. At one point, a technician lifted his wounded leg to clean it, and the weakened tibia fractured with a sharp crack that sent shudders through the surgical staff. But the blocks were so effective, Wilhelm didn't even feel it.

    The typical scene in the recovery tent is a somber one: friends touching the sides of the bed around an unconscious soldier in a silent show of support. By contrast, when Wilhelm's operation was over, 15 of his buddies crowded around, laughing and joking with him.

    Later, Wilhelm's catheters were connected to pumps, each about the size of a TV remote control and weighing only about 6 ounces, with tiny LCD screens. Hooked up to a supply of ropivacaine, they would provide continuous anesthesia for 48 hours on two AA batteries. The entire apparatus fit in a fanny pack.

    The advantage of delivering anesthesia locally to the damaged nerves rather than to the brain (which is where morphine and general anesthesia work their magic) is that it seems to reduce the incidence of chronic pain once the injury has healed. It also keeps the patient awake and alert and better able to participate in his own medical care.

    Read the whole article. It's a fascinating account.


    posted by Sydney on 2/09/2005 07:15:00 AM 1 comments


    This is interesting and it truly amazes me as to how much our world advances in medicine. The human mind a is beautiful creation!


    By Anonymous Anonymous, at 5:44 PM  

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